Chemical information based monitoring window

Abstract

Systems and methods are disclosed to trigger a diuresis monitoring window, including determining a health index for a patient as a function of received physiologic information, determining a health index alert state for the patient using a value of the determined health index and a health index alert threshold, monitoring the health index in the health index alert state, triggering, in response to a detected change in the health index in the health index alert state indicating an improved patient condition, a start of the diuresis monitoring window, receiving chemical information of the patient during the diuresis monitoring window, and monitoring a chemical parameter of the patient during the diuresis monitoring window using the received chemical information.

What is claimed is: 
     
         1 . A medical device system, comprising:
 a signal receiver circuit configured to receive physiologic information of a patient; and   an assessment circuit configured to:
 determine a health index for the patient as a function of the received physiologic information, 
 determine a health index alert state for the patient using a value of the determined health index and a health index alert threshold; 
 monitor the health index in the health index alert state; and 
 in response to a detected change in the health index in the health index alert state indicating an improved patient condition, trigger a start of a diuresis monitoring window, 
   wherein the signal receiver circuit is configured to receive chemical information of the patient during the diuresis monitoring window,   wherein the assessment circuit is configured to monitor a chemical parameter of the patient during the diuresis monitoring window using received chemical information.   
     
     
         2 . The medical device system of  claim 1 , wherein the health index includes a composite health index, wherein the assessment circuit is configured to determine the composite health index for the patient as a function of at least two features of the received physiologic information. 
     
     
         3 . The medical device system of  claim 1 , wherein to determine the health index alert state for the patient comprises to determine a health index in-alert state for the patient using the value of the determined health index and a health index in-alert threshold,
 wherein to monitor the health index comprises to monitor the health index in the health index in-alert state,   wherein to trigger the start of the diuresis monitoring window comprises in response to a detected change in the value of the health index in the health index in-alert state towards the health index in-alert threshold or a health index out-of-alert threshold greater than a first threshold, indicating the improved patient condition.   
     
     
         4 . The medical device system of  claim 1 , wherein to monitor the chemical parameter of the patient comprises to determine a value of the chemical parameter of the patient using the received chemical information, to monitor the determined chemical parameter during the diuresis monitoring window, and to determine a chemical alert state for the patient if the value of the determined chemical parameter exceeds a chemical alert threshold in the diuresis monitoring window,
 wherein the assessment circuit is configured to provide an output of the determined chemical alert state to a user interface for display to a user or to a control circuit to control or adjust a process or function of the medical device system.   
     
     
         5 . The medical device system of  claim 4 , wherein the chemical alert threshold is determined as a function of a detected rate of change of the value of the determined chemical parameter in at least a portion of the diuresis monitoring window. 
     
     
         6 . The medical device system of  claim 4 , wherein the health index includes a heart failure index,
 wherein the chemical parameter or the chemical information includes at least one of potassium information or a creatinine information of the patient.   
     
     
         7 . The medical device system of  claim 1 , wherein the health index alert state comprises one of a health index in-alert state and a health index out-of-alert state,
 wherein the diuresis monitoring window includes an initial duration comprising a first time period following a detected transition from the health index in-alert state to the health index out-of-alert state.   
     
     
         8 . The medical device system of  claim 7 , wherein the first time period has an initial duration comprising a predefined number of days, the predefined number between 3 days and 31 days. 
     
     
         9 . The medical device system of  claim 7 , wherein the assessment circuit is configured to extend a duration of the diuresis monitoring window in response to the received chemical information crossing a first chemical alert threshold during the initial duration of the diuresis monitoring window,
 wherein the assessment circuit is configured to end the extended duration of the diuresis monitoring window in response to the received chemical information crossing a second chemical alert threshold during the extended duration of the diuresis monitoring window.   
     
     
         10 . The medical device system of  claim 1 , wherein to monitor the chemical parameter of the patient comprises to determine a value of the chemical parameter of the patient using the received chemical information, to monitor the determined chemical parameter during the diuresis monitoring window, and to determine a chemical alert state for the patient if a rate of change of the value of the determined chemical parameter exceeds a chemical rate of change threshold in the diuresis monitoring window,
 wherein the assessment circuit is configured to provide an output of the determined chemical alert state to a user interface for display to a user or to a control circuit to control or adjust a process or function of the medical device system.   
     
     
         11 . The medical device system of  claim 1 , wherein the alert state comprises one of an in-alert state and an out-of-alert state,
 wherein the assessment circuit is configured to trigger the start of the diuresis monitoring window in response to a detected transition from the in-alert state to the out-of-alert state.   
     
     
         12 . A method, comprising:
 receiving, using a signal receiver circuit, physiologic information of a patient; and   using an assessment circuit:
 determining a health index for the patient as a function of the received physiologic information, 
 determining a health index alert state for the patient using a value of the determined health index and a health index alert threshold; 
 monitoring the health index in the health index alert state; and 
 triggering, in response to a detected change in the health index in the health index alert state indicating an improved patient condition, a start of a diuresis monitoring window; 
   receiving, using the signal receiver circuit, chemical information of the patient during the diuresis monitoring window; and   monitoring, using the assessment circuit, a chemical parameter of the patient during the diuresis monitoring window using received chemical information.   
     
     
         13 . The method of  claim 12 , wherein the health index comprises a composite health index, and wherein determining the health index includes determining the composite health index for the patient as a function of at least two features of the received physiologic information. 
     
     
         14 . The method of  claim 12 , wherein determining the health index alert state for the patient comprises determining a health index in-alert state for the patient using the value of the determined health index and a health index in-alert threshold,
 wherein monitoring the health index comprises monitoring the health index in the health index in-alert state,   wherein triggering the start of the diuresis monitoring window comprises in response to a detected change in the value of the health index in the health index in-alert state towards the health index in-alert threshold or a health index out-of-alert threshold greater than a first threshold, indicating the improved patient condition.   
     
     
         15 . The method of  claim 12 , wherein monitoring the chemical parameter of the patient comprises determining a value of the chemical parameter of the patient using the received chemical information, monitoring the determined chemical parameter during the diuresis monitoring window, and determining a chemical alert state for the patient if the value of the determined chemical parameter exceeds a chemical alert threshold in the diuresis monitoring window,
 wherein the assessment circuit is configured to provide an output of the determined chemical alert state to a user interface for display to a user or to a control circuit to control or adjust a process or function of a medical device system.   
     
     
         16 . The method of  claim 15 , comprising determining the chemical alert threshold as a function of a detected rate of change of the value of the determined chemical parameter in at least a portion of the diuresis monitoring window, wherein the health index includes a heart failure index, wherein the chemical parameter or the chemical information includes at least one of a potassium information or creatinine information of the patient. 
     
     
         17 . The method of  claim 12 , wherein the health index alert state comprises one of a health index in-alert state and a health index out-of-alert state,
 wherein the diuresis monitoring window includes an initial duration comprising a first time period following a detected transition from the health index in-alert state to the health index out-of-alert state.   
     
     
         18 . The method of  claim 17 , comprising:
 extending, using the assessment circuit, a duration of the diuresis monitoring window in response to the received chemical information crossing a first chemical alert threshold during the initial duration of the diuresis monitoring window; and   ending, using the assessment circuit, the extended duration of the diuresis monitoring window in response to the received chemical information crossing a second chemical alert threshold during the extended duration of the diuresis monitoring window.   
     
     
         19 . The method of  claim 12 , wherein monitoring the chemical parameter of the patient comprises determining a value of the chemical parameter of the patient using the received chemical information, monitoring the determined chemical parameter during the diuresis monitoring window, and determining a chemical alert state for the patient if a rate of change of the value of the determined chemical parameter exceeds a chemical rate of change threshold in the diuresis monitoring window,
 wherein the method comprises providing, using the assessment circuit, an output of the determined chemical alert state to a user interface for display to a user or to a control circuit to control or adjust a process or function of a medical device system.   
     
     
         20 . The method of  claim 12 , wherein the alert state comprises one of an in-alert state and an out-of-alert state,
 wherein the method comprises triggering, using the assessment circuit, the start of the diuresis monitoring window in response to a detected transition from the in-alert state to the out-of-alert state.